Paging Dr. Whitney Roban, Ph.D: There’s More To Sleep-Training Than Just “Cry It Out”

Dr. Whitney Roban, Ph.D., of Sleep-Eez Kids, is back to offer some more thoughts on that touchy topic: sleep-training.  Although there are many, many different methods to “sleep train” our little ones, many people hear that phrase and immediately think “cry it out”.  I thought we could all use a little refresher on the wide variety of options that we as parents have when trying to help our children learn how to become excellent little sleepers.  Even if you think sleep training isn’t for you, you may find something you can use in these summaries!   xxRosie

A Guest Post: There’s More To Sleep-Training Than Just “Cry It Out”

My previous guest blog post was about whether sleep training was right for your family.  Assuming you decided that you want to proceed with sleep training, deciding on how to proceed is the next step.  In my practice, some of my moms contact me having read every book, website and blog about sleep.  These mom, while knowledgeable, are often very confused about which sleep training technique to use.  Some of my other moms haven’t gathered any information and are looking to me for advice as to which method will work best for their family.  Therefore, I think it will be helpful to discuss the three most popular methods of sleep training and hopefully answer some questions that you may have.

Gradual Parent Removal Method / Chair Method

The first method I will talk about is the Gradual Parent Removal Method, also known as “The Chair Method”.  This method is most often used by parents who want their child to learn to fall asleep unassisted but want to reassure their child that they are there.  The parent puts the child in his crib awake and then the parent sits on a chair close to the crib until the child falls asleep.  After two nights, the chair is moved further away from the crib.  The parents proceed to sit in the chair the following two nights, and then move the chair even further from the crib for nights five and six.  By night seven the parent is no longer in the child’s room and the hope is that the child has learned to self soothe by this point in time.  This approach can work with 100% consistency and a lot of patience.  However, it often fails because it takes one week and it is very difficult for a parent to avoid engaging with the child while sitting in his room while the child learns to self soothe.  This method can also be very confusing to a young child.  He may not understand why the parent is in his room but not picking him up and helping him get back to sleep as the parent has done in the past.

Dr. Ferber’s Graduated Extinction Approach / The Progressive Approach

The second method, and probably the most well known, is Dr. Richard Ferber’s Graduated Extinction Approach (also known as “The Progressive Approach”).  This method uses a progressive time approach for parents to “check and recheck” on the child in order to extinguish the behavior to be changed, which is the protest crying and the night wakings.  On the first night of sleep training, the parents wait 5 minutes before checking in on their child.  On the 2nd waking, the parents wait 10 minutes before checking in on their child.  On the 3rd waking, the parents wait 15 minutes before checking in on their child.  For all future wakings that night, the parents stay with the 15 minute time gap before checking in on their child.  On night two of sleep training, the parents check in at 10 minutes, then 15 minutes, and then 20 minute intervals for the rest of the night.  The interval of check in times increases by 5 minutes every night.  It is important to note that when the parents check in on the child, they do not pick up or physically soothe the child at any time.  The parents stay in the child’s room for about 30 seconds, just to reassure the child that they are there, and they then leave the room before the child falls asleep.  This method takes, on average, one week to work.  Therefore, although it has great success when utilized with 100% consistency on the part of the parents, it does fail when parents have a difficult time being 100% consistent for one week straight.

Dr. Weissbluth’s Extinction Method

The third method, Dr. Marc Weissbluth’s Extinction Method, is based on the theory that the behavior to be changed (the protest crying and the night wakings) will end if they are no longer being reinforced by the parents.  This means neither positively or negatively reinforcing the behavior.  In this method, caregivers allow the child to learn to self soothe without interfering or being present during this key process.  During the learning of this new and critical skill, there will most likely be protest crying as the children are reacting to many changes in sleep routines and schedules.  Most people do not like change and the protest crying is the result of adapting to change and learning a new skill.  Dr. Weissbluth stresses the importance of distinguishing the cry response as one of a “want” (i.e., I want you to rock me, feed me, bounce me, stroll me…) as opposed to a “need” (i.e., I need you because I am sick or hurt).  This method generally takes two to three nights to work and it’s successes are a direct result of the parent’s ability to stay 100% consistent for this shorter amount of time.  Also, witnessing improvements within a short amount of time is also motivating to parents to continue on with the sleep training and stay consistent.

Although choosing the right sleep training method is important for a family, it is also important to be aware of the other central components of healthy sleep that often get overlooked.  These include the importance of a consistent and developmentally appropriate 24 hour sleep schedule (including naps), an early bedtime, and a consistent bed time and nap time routine.  These components must be present in your sleep training program in order to have success.  Even if you never sleep train your child, it is helpful to include these components in your child’s daily sleep life.

Above all else, the key to all sleep training is 100% consistency and allowing your child the opportunity to master the self soothing skill.  Any and all sleep training methods will eventually work if you are 100% consistent.  However, anything less than 100% consistency will not lead you to the results you need and deserve.  Remember, although 4 months and 14 pounds is the earliest you may begin to sleep train your child, it is never too late to teach a child good sleep habits and get your family well rested!

Tags: cry it out, momprep, rosie pope, sleep training, weissbluth